Provider Demographics
NPI:1518311323
Name:GHEBEY, EUGENE ABONGHA I
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:ABONGHA
Last Name:GHEBEY
Suffix:I
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:EUGENE
Other - Middle Name:ABONGHA
Other - Last Name:GHEBEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9327 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:240-510-4969
Mailing Address - Fax:
Practice Address - Street 1:9327 4TH STREET
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:240-510-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient